| NPI | 1508125170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH A BERDICK President 239-334-4157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0017772) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL NP1971252) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-09-24 |