| NPI | 1538231956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM G JACKSON Executive Director 941-309-7006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1114) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2010-12-30 |