| NPI | 1841173945 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BEAU A ARCHIBALD Owner / Managing Member 863-558-6605 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 208VP0000X | 
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine | 
| 2086S0102X Surgery, Surgical Critical Care | |
| 2086X0206X Surgery, Surgical Oncology | |
| 207RN0300X Internal Medicine, Nephrology | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207RX0202X Internal Medicine, Medical Oncology | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| Enumeration Date | 2025-07-28 | 
| Last Update Date | 2025-07-28 |