| NPI | 1487759809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RAYMOND LASTOMIRSKY Owner/Operator 941-484-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0032829) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-12-04 |