| NPI | 1376296152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KALOUST Manager 813-228-6334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2023-01-05 |