| NPI | 1629355532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD KERR DYCUS Owner Operator 407-706-6688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS0008481) |
| Enumeration Date | 2011-11-05 |
| Last Update Date | 2024-01-19 |