| NPI | 1275770968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SHIREY Executive Director 941-917-8720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME91036) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| 207VX0000X Obstetrics & Gynecology, Obstetrics | |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2018-04-17 |