| NPI | 1851651988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY TAYLOR KLOSSNER Director 352-333-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL N12000000613-VHCPP) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2013-12-04 |