| NPI | 1871361519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIUBER CASTILLO COO 239-692-6024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 225100000X Physical Therapist | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2023-12-12 |
| Last Update Date | 2024-03-28 |