| NPI | 1821218488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL GRUDEM President 352-629-7011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME 61060) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2008-06-27 |