| NPI | 1144678376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA PASSALACQUA Owner 941-957-8924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9193819) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |