| NPI | 1538870696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE LIZ DE LA VEGA A RN P Fnp 239-848-9026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2024-01-24 |