| NPI | 1578608097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY MEADOWS Vice President 727-507-3610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2008-02-08 |