| NPI | 1154652576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA V KULICK Director/Presidnt 727-940-3478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: FL ME103499) |
| 208D00000X General Practice (Licence: FL ME103499) | |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2015-02-25 |