| NPI | 1407128234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE MILTON PETTY Physician 727-548-1232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME68819) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |