| NPI | 1942285770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA GONZALEZ Practice Administrator 941-202-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0055206) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2025-09-22 |