| NPI | 1356544605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA G BUTLER Compliance Specialist 941-917-8345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME53423) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2008-08-07 |