| NPI | 1023864147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUELLYN PANDIS Director Of Clinical Practice 813-396-0234 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-04-29 |