| NPI | 1639503899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN HEALY Owner 239-565-9529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL MM28453) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2013-08-23 |