| NPI | 1942640057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADAPO O SHYNGLE Medical Director 863-422-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL ME 94349) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2014-07-21 |