| NPI | 1932503851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE GHANEM CEO 239-768-6396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL HCC9815) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2020-08-21 |