| NPI | 1639213101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRUCE DESTEPHENS Md 352-371-1804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME0045204) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2020-08-22 |