| NPI | 1457371213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE CASELNOVA President/Owner 813-782-2646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME45762) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |