| NPI | 1700162468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMLYN LOUIS CEO/President 239-288-0840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: FL tax59) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2022-10-26 |