| NPI | 1932531035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN D FRASER Owner 352-369-5878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME30256) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2013-07-31 |