| NPI | 1972819894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THIRUVALLUR E VALLABHAN Physician Owner 352-638-1705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-31 |