NPI | 1770973729 |
---|---|
Entity Type | Organization |
Authorized Contact | SHEILA KEENE-LUND Office Manager 352-750-4333 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL 605594) |
Enumeration Date | 2015-01-29 |
Last Update Date | 2015-01-29 |