| NPI | 1720868128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI LORD Authorized Person 352-650-3446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2023-10-05 |