| NPI | 1962825794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON BURDZY Managing Physician 239-275-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2024-12-10 |