| NPI | 1598282113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEEJA JACOB Director 407-520-9377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |