| NPI | 1750313144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK HARRIS Administrator 321-453-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 849) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2013-05-20 |