| NPI | 1952574923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN DUMAYAS TESALONA M.D./Owner 352-315-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0063400) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2011-12-08 |