| NPI | 1356939284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA MARIE PREBECK VP Of Operations 727-559-9461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-01-06 |