| NPI | 1649165309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRICE NICOLE STEWART President/CEO 407-676-9866 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-09-22 |