| NPI | 1588116131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE LAWSON Chief Operating Officer 813-549-2134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-10-31 |