NPI | 1407641756 |
---|---|
Doing Business As | BAYOUSIDE HEALTH & WELLNESS |
Entity Type | Organization |
Authorized Contact | LARA CORTES Practice Owner 727-935-1185 |
Organization Subpart ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
Enumeration Date | 2025-04-09 |
Last Update Date | 2025-04-09 |