| NPI | 1548290703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS LOPEZ CEO 352-861-5765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me55323) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 416402) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |