| NPI | 1972788537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD AFZAL Owner 352-394-3929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: FL ME72542) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME72542) |
| 208000000X Pediatrics (Licence: FL ME72542) | |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2015-09-30 |