| NPI | 1508449075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS ALLEN Authorized Officiail 407-601-1370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-05-03 |