| NPI | 1679167134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BYRON R DEAN Manager 863-937-7157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207Q00000X Family Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-02-25 |