| NPI | 1548700115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LAMONT SALAGUBANG D.O./Owner 407-814-2680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME87564) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME 87564) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2021-04-12 |