| NPI | 1043307929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P HANLEY Sec Tres 727-443-2679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME9201) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME12648) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-07-16 |