| NPI | 1881065662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HECTOR LOPEZ Clinical Director 352-689-7332 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 133531-1) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-19 |