| NPI | 1861990855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED MANSOUR Owner/Physician 407-620-3003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-04-10 |