| NPI | 1609537992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINA FAGER Board Member/Administrator 239-624-6946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2025-03-07 |