| NPI | 1508802604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN G SYMEONIDES Physician 386-864-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL ME83577) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2010-01-27 |