| NPI | 1619275856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA V KULICK President 727-940-3478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: FL ME 103499) |
| Enumeration Date | 2011-03-12 |
| Last Update Date | 2011-03-12 |