| NPI | 1679729271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE M. CROFOOT Owner 407-894-4330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME43757) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |