| NPI | 1285393694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BAGBY Ambr 727-415-2308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 170300000X Genetic Counselor, MS | |
| 208D00000X General Practice | |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 251J00000X Nursing Care | |
| 261QG0250X | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0800X Clinic/Center, Recovery Care | |
| 261QV0200X Clinic/Center, VA | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2022-04-24 |