| NPI | 1568549087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY DOORNBOS Billing/Credentialing 727-816-9427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME58035) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-02-07 |