| NPI | 1609950674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM STANLEY PERRY Clinic Administrator 727-535-1437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-09-24 |