| NPI | 1568805679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS MICHAEL NUSSBAUM President 813-689-2961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 49552) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2013-04-09 |