| NPI | 1811849763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESITA RYAN Manager 407-246-1970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2026-02-12 |
| Last Update Date | 2026-05-28 |