| NPI | 1184107070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BACKUS-WADE Practice Manager 941-629-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME107666) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |