| NPI | 1841392339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA KIRKLAND Director 321-449-4537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2020-08-22 |