| NPI | 1578733614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD R CHACE Vice President 941-473-2913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME48779) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS5249) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME61249) | |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2008-03-05 |