| NPI | 1336461763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY A WELLING Credentialing Specialist 727-863-5263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: FL ME0068848) |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2010-02-26 |