| NPI | 1871644096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVONNE MARIE LABONTE CEO Administrator 941-366-8897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2022-07-21 |