| NPI | 1982101572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMALA MARION ROY Busines Manager 352-409-3680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 13607) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |