| NPI | 1639698939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUZ D ROSARIO-MAISONET President 352-204-9866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN203) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2021-07-13 |