| NPI | 1376925602 |
|---|---|
| Doing Business As | MEDI-WEIGHTLOSS |
| Entity Type | Organization |
| Authorized Contact | EDWARD KALOUST Manager Member 813-228-6334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: AZ 500010862) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |