| NPI | 1134470255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAN THANG TRAN President 813-253-0711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL OS10332) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME 84580) |
| 208D00000X General Practice (Licence: FL PA 9104287) | |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2015-03-12 |