NPI | 1346998291 |
---|---|
Entity Type | Organization |
Authorized Contact | KATRINA MERRITT Senior Manager, Credentialing 813-596-5726 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
2084A0401X Psychiatry & Neurology, Addiction Medicine | |
208D00000X General Practice | |
Enumeration Date | 2022-03-10 |
Last Update Date | 2024-01-15 |