| NPI | 1790871424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD JOHN DIPASCO Medical Director 239-390-2032 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2011-01-13 |