| NPI | 1003553785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY HEALD Mgr 813-228-6334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine Obesity Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-05-31 |