| NPI | 1619140662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH DENNIS BAXLEY President 352-368-2448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME100494) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME100494) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2014-10-01 |