| NPI | 1366888166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY ALLEN PROSSER President 813-943-1684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME 81606) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2022-10-27 |