| NPI | 1043252307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HANSON RAUCH Manager 321-273-0301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-08-22 |