| NPI | 1992825145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLENE A. WILSON Owner/Physician 352-795-2459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME93743) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME93743) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2014-06-05 |