| NPI | 1609541069 |
|---|---|
| Other Name | COUNTRYSIDE |
| Entity Type | Organization |
| Authorized Contact | LYNDA GORKEN VP, PFS 727-281-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2021-08-09 |