| NPI | 1881831238 |
|---|---|
| Doing Business As | MEDERO MEDICAL LAKE |
| Entity Type | Organization |
| Authorized Contact | LARRY MAYFIELD Administrator 352-629-3433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL 12664) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |