NPI | 1578228375 |
---|---|
Other Name | ATTN: JAMIE BUS ADAM SILVER |
Entity Type | Organization |
Authorized Contact | RAVEN MAYES Osteopathic Medicine Physician 352-792-8069 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 174200000X Meals |
251E00000X Home Health | |
251J00000X Nursing Care | |
251S00000X | |
261QA0005X Clinic/Center, Ambulatory Family Planning Facility | |
261QE0002X Clinic/Center, Emergency Care | |
332100000X Department of Veterans Affairs (VA) Pharmacy | |
333600000X Pharmacy | |
385H00000X Respite Care | |
Enumeration Date | 2021-11-05 |
Last Update Date | 2021-11-05 |