| NPI | 1700988813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY A CUMBESS Office Manager 239-337-9422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS5829) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2010-03-19 |