NPI | 1609546993 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANK MAZZEO President/CEO 239-278-3600 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2021-09-17 |
Last Update Date | 2022-06-21 |