| NPI | 1649378498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL SHEPARD Office Manager 321-631-5677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |