| NPI | 1114242120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE C CLARKE President 813-789-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 2511202) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2010-04-01 |