| NPI | 1508222324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED MARK DORTON Market Manager 813-283-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME112401) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |