| NPI | 1700130721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARYLE LYNE CLYATT Officer 239-939-1999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME59299) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME92164) |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2013-08-30 |