| NPI | 1417256033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA BRADSHAW Physician/Owner 813-810-1688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME83385) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2011-03-22 |