| NPI | 1124440912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA M PREBECK VP Of Operations 727-581-8767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2020-11-25 |