| NPI | 1619900248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY F JACKSON Schedule COO RN Idator 727-384-2016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME48637) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2009-06-18 |