| NPI | 1831544832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVETTE A CHARNECO Office Administrator 407-846-0533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261Q00000X Clinic/Center | |
| 208000000X Pediatrics | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-10-04 |