NPI | 1528892049 |
---|---|
Entity Type | Organization |
Authorized Contact | PAMELA WAGENER Owner/Authorized Official 407-624-2844 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine |
207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
Enumeration Date | 2024-08-27 |
Last Update Date | 2024-11-12 |