| NPI | 1235160805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HOLSTEN Administration 727-844-5404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS0007067) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2013-07-01 |