| NPI | 1851718563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YINA D FRASURE Practice Administrator 407-412-9226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL ME69749) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2014-03-20 |