| NPI | 1639650161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKY LUCIA Chief Administrative Officer 239-963-7365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |