| NPI | 1992729354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ANN YINGLING Billing Manager 941-584-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-07-12 |