| NPI | 1942500855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARDO FELICIANO Member 239-314-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME105191) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2011-08-05 |