| NPI | 1194766550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEENA C KOPPUZHA Physician 941-475-6568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0075143) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2010-07-16 |