| NPI | 1992082721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENIFER O OLIVEIRA Credentialer 239-210-0132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME102280) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2011-11-08 |