| NPI | 1154350858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN NESSETTI-PRATHER Practice Administrator 941-388-8997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 207V00000X Obstetrics & Gynecology | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-05-15 |