| NPI | 1710401302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREL DOTAS Chief Operating Office 352-215-1603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2024-04-01 |