| NPI | 1023721529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI DESPOY Secretary And Treasurer 813-228-6334 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2023-08-17 |