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 |