| NPI | 1740251909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI PARKER Director 352-333-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: FL 1085) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-02-08 |