| NPI | 1902969850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY D MCLEMORE Sr Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208600000X Surgery |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2009-10-07 |