| NPI | 1013967843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA COSTOPOULOS Administrator 941-365-8532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2012-12-26 |