| NPI | 1588759484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL JEANNE BONILLA Administrator 813-254-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me0046378) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-05-28 |