| NPI | 1629075874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMARA L VANDERGRAFF Office Manager 727-593-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL OS0007369) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2020-08-22 |