| NPI | 1558039719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICRUZ NIEVES Director Of Billing & Managed Care 407-905-8827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2021-09-02 |