| NPI | 1659320992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA C. SMITH Office Manager 727-443-3295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME0012503) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME0029348) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME0043485) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME74317) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-08-22 |