| NPI | 1992196711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAGDI FARIS Owner 352-629-9566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME27677) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2015-02-16 |