| NPI | 1710465679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN MOURA Co Owner 407-388-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 251E00000X Home Health | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2023-02-10 |