| NPI | 1720090749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WISTERIA Y WYCHE Office Manager 407-839-5063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME41485) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2011-04-20 |