| NPI | 1699121301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISELA DOMINGUEZ Chief Medical Director 352-512-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL ME102787) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |