| NPI | 1558582254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M TATUM Owner 407-644-3593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0030885) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2017-05-17 |