NPI | 1770144065 |
---|---|
Entity Type | Organization |
Authorized Contact | DEAN C MAJOR AO 352-634-8736 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2019-06-26 |
Last Update Date | 2023-04-06 |