| NPI | 1568818110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMEEL AUDEH Owner/President 941-685-4929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: NC 2015-02345) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-05-12 |