NPI | 1801689898 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY J MALDONADO CEO 321-285-9907 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
Additional Taxonomies | 207Q00000X Family Medicine |
3336C0002X Pharmacy Clinic Pharmacy | |
Enumeration Date | 2025-05-23 |
Last Update Date | 2025-08-13 |