| NPI | 1578955928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DULCE A TANGUNAN Billing Manager 863-314-8440 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME56385) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |