| NPI | 1588076533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOREEN GALL Owner 352-636-8042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 3189902) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |