| NPI | 1720362429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN THOMPSON Manager/A RN P/Co Owner 386-243-8474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 2667852) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9220069) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2014-02-19 |