| NPI | 1194086124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY MOORE Front Office 727-343-2741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0044988) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-26 |