NPI | 1740952365 |
---|---|
Entity Type | Organization |
Authorized Contact | LANCE GREEN EVP/CFO 863-687-1100 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
207R00000X Internal Medicine | |
207RI0200X Internal Medicine, Infectious Disease | |
208D00000X General Practice | |
Enumeration Date | 2021-10-01 |
Last Update Date | 2023-01-04 |