| NPI | 1649593773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DANIEL BOEHM Owner / Provider 813-752-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME55585) |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2010-08-09 |