| NPI | 1619468899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CATHERINE MACK Nurse Practitioner/Owner 352-888-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP3156902) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |