| NPI | 1750587903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA DANIEL President 239-417-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL HCC7141) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-22 |