| NPI | 1790737922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALTON M BENSON Owner 352-597-3511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL 2005-00475004) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2012-07-25 |