| NPI | 1811995137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL M. MODICA Administrator 407-708-5383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: FL 1225) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2020-08-22 |