| NPI | 1861535726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA FAY DELO President 772-871-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: FL OS05326) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2010-07-09 |