| NPI | 1538914429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MARTINEZ Senior Credentialing Professional 407-447-7120 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2024-08-19 |