| NPI | 1891944211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSON LEE DIEHL Managing Member 407-257-7239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL MM21115) |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2008-10-01 |