| NPI | 1770710766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GINGRAS Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| 208600000X Surgery | |
| 367A00000X Advanced Practice Midwife | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2012-11-26 |