| NPI | 1003016858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER ALLEN KOSOFF Owner 813-236-9310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME79005) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |