| NPI | 1376629089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE R DAVIS Physician 813-899-2015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL OS5749) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2008-03-05 |