| NPI | 1932246501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY S PACKER Practice Manager 407-370-9783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME-75691) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2019-04-08 |