| NPI | 1851697023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK H MONTGOMERY Owner/Physician 239-495-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME84347) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2011-03-22 |