| NPI | 1609342708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAMATO Manager/Provider 941-896-5845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2020-10-01 |