| NPI | 1649293648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE ENTREKIN Office Manager 352-377-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 016400509) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-08-16 |