| NPI | 1912560442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE BARBARA AUGUSTIN Office Manager 407-271-8845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207R00000X Internal Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-04-19 |