| NPI | 1548626880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA STELLATO Practice Administrator 321-733-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9288128) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |