| NPI | 1053315572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA DEMENT Practice Administrator 941-955-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS8062) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics (Licence: FL OS8062) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2023-09-25 |