| NPI | 1487086914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL BOTBYL Certified Practice Manager 727-726-1460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |