| NPI | 1922049303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE T WEEKES CEO 352-404-4523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL 8760009368) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-19 |