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 |