| NPI | 1770908956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER SPENCER Medical Director 352-267-9170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL 201401150006) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2014-03-13 |