| NPI | 1205024304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL KELLY Practice Administrator 941-924-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME81031) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2007-10-31 |