| NPI | 1114233012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA L LALLIER Credentialing/Coding Manager 321-362-5128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2022-09-15 |