| NPI | 1972708162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ROSE BOEHM President 352-242-1430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL me88288) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |