| NPI | 1255319976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD KUCHER Chief Regulatory Officer 727-824-8100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2024-10-17 |