| 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 |