| NPI | 1174793871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY FOX Office Administrator 727-484-6169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME53805) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2024-06-05 |