| NPI | 1245693530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANI V. DAVIS Anp Bc 813-936-2609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Additional Taxonomies | 163WD0400X Registered Nurse Diabetes Educator |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2017-03-01 |