| NPI | 1780074831 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DAVID C BLUMER Sole Proprietor 352-372-1878 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 30193) | 
| Enumeration Date | 2015-01-28 | 
| Last Update Date | 2015-01-28 |