| NPI | 1275730970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM A BRUNSON President 727-561-4303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: FL ME80751) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2011-05-12 |