| NPI | 1578962320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK DANG Manager 407-851-2790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL ME98622) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2015-07-15 |