| NPI | 1558150755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VADYM DIDENKO CFO 813-803-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-05-05 |