| NPI | 1144612623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TIMOTHY REILLY President 727-821-1132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME32973) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2015-02-20 |