| NPI | 1649679341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFRED ETAPU ALINGU Owner 352-596-0405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME77939) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |