| NPI | 1184456881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GOWTHAMAN PANDIAN COO 813-816-5124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |