| NPI | 1477058691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANCHAMI THOMAS President 727-424-8419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9253922) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-08-15 |