| NPI | 1649457482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY M THOMAS Physician 813-597-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL ME82489) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: FL ME82489) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2009-01-27 |