| NPI | 1700876703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISH A DANIELS Administrator 772-589-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1034) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2012-12-04 |