| NPI | 1952900953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA LEE MERCADO Ap RN 386-281-0939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |