| NPI | 1801914858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN CAROL MOSS Physician And Owner 321-752-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME22466) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |