| NPI | 1871853150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY SIBISKI Executive Vice President 352-265-8017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2016-10-27 |