| NPI | 1538719828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GROVE Executive Director 727-744-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-12-13 |