| NPI | 1790124741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN LY President 407-705-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME114777) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-21 |