| NPI | 1801773965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE BRIDGMAN CEO 352-801-9272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-20 |