| NPI | 1205872710 |
|---|---|
| Former Legal Business Name | MALCOLM ROOT MD PA |
| Entity Type | Organization |
| Authorized Contact | MALCOLM ROOT Owner President 813-253-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL 05 8026) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2008-03-04 |