| NPI | 1588839609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA PERRINE Administrator 941-782-5439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1304) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2025-02-05 |