NPI | 1821677659 |
---|---|
Entity Type | Organization |
Authorized Contact | JON BURDZY Managing Physician 239-275-5522 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Additional Taxonomies | 363L00000X Nurse Practitioner |
363LF0000X Nurse Practitioner, Family | |
363LP0200X Nurse Practitioner, Pediatrics | |
Enumeration Date | 2021-04-07 |
Last Update Date | 2024-08-13 |