| NPI | 1538443825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA BARAJAS Manager 941-769-2474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL AP2956) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |