| NPI | 1043407323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE L CLARK Office Manager 727-545-8887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0053333) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2010-07-28 |