| NPI | 1104920826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PALLAVI K PATEL Administrator 813-239-3262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME0039612) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2013-02-11 |