| NPI | 1740645357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK M LOMANO Physician 239-470-8809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME33323) |
| Enumeration Date | 2015-12-24 |
| Last Update Date | 2015-12-24 |