| NPI | 1942270905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOELLE M INNOCENT-SIMON Medical Doctor 352-468-1735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL os0006902) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2011-03-22 |