| NPI | 1578831640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM T BRANCH Physician 813-877-0463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL 19758) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2011-12-05 |