| NPI | 1851146500 |
|---|---|
| Doing Business As | 1 PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | JOHN DISTEFANO Business Manager 352-317-3214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |