| NPI | 1932106119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PARKER Insurance Billing Coordinator 352-479-0149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2022-07-21 |