| NPI | 1750983631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GUYER CEO 321-387-2980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-11-15 |
| Last Update Date | 2021-03-16 |