| NPI | 1508215245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN CLAUSSEN CEO 863-291-5110 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2019-01-25 |