| NPI | 1518074871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M MEYER Owner 863-385-5972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME73407) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 09302R) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |