NPI | 1770830630 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT A DEMETREE President 321-439-7122 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL OF0003780) |
Enumeration Date | 2012-08-10 |
Last Update Date | 2012-08-10 |