| NPI | 1801110622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA PELLETIER Owner 941-744-9770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL AP1663) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2015-04-29 |