| NPI | 1851146468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE GREEN EVP/CFO 863-687-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-04-18 |
| Last Update Date | 2024-11-18 |