| NPI | 1821677659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C YANKASKAS 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 | 2021-04-08 |