| NPI | 1871253526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMECA BAKKER Owner 239-294-1607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2021-12-22 |