| NPI | 1447521612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ROBERSON Director 813-615-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME67567) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-09-17 |