| NPI | 1518147347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN V WALKER President 772-283-5431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME69055) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2008-01-23 |