| NPI | 1093202061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE ANN EDWARDS Owner 813-416-8934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL arnp9197542) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |