| NPI | 1447516141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS PUDOL Medical Director 813-963-1982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL OS8199) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |