| NPI | 1639454945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY CHARLES COURVILLE President 239-403-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 62168) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2011-10-18 |