| NPI | 1316363161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANNE BRUNTON COOLEY Clinic Owner/ Manager 813-792-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2776972) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2015-09-24 |