| NPI | 1528465499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER L SEIFERT Owner 321-280-3949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME108299) |
| Additional Taxonomies | 261Q00000X (Licence: FL ME10299) |
| 261QE0002X Clinic/Center, Emergency Care (Licence: FL ME108299) | |
| 305S00000X Point of Service (Licence: FL ME108299) | |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2014-11-20 |