| NPI | 1992734982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANGELO ANDERSON Partner 352-303-6143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: FL PMD510306) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME31278) |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL ME31278) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-08-22 |