| NPI | 1467873315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD KUCHER Chief Regulatory Officer 727-824-8100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2024-10-17 |