| NPI | 1750954566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L BECKER Owner, Practicing Physician 239-207-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2021-07-20 |