| NPI | 1689356685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MARTIN VICK LLC Owner Member 352-396-3041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 305S00000X Point of Service | |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2024-05-01 |