| NPI | 1205030517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE L WARREN Physician 727-298-8338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL AW5248439) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |