| NPI | 1376319160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER TRAVIS RIAD CHANG VP Healthcare Design 813-844-3829 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0206X Clinic/Center Radiology, Mammography |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery | |
| 207X00000X Orthopaedic Surgery | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 208600000X Surgery | |
| 261QR0200X Clinic/Center Radiology | |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2024-03-27 |