| NPI | 1093726481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT L RAY Owner 727-797-3155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL osooo4600) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-11-29 |