| NPI | 1194825588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW ALEXANDER FETCHIK Vice Presiden 727-569-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS6553) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2011-02-04 |