| NPI | 1770900722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE JONES FOLKMAN Owner 813-245-2258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: FL ME48476) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-03-27 |