| NPI | 1326308313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER LEE TEDDER Medical Assistant 321-723-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME22385) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2012-05-23 |