| NPI | 1922197508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J. VALLILLO Doctor 407-425-4901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 5359) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |