| NPI | 1760818488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD C MALLONEE President 407-492-8950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL OS6833) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2013-09-26 |