| NPI | 1669861621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALINI MCDONALD Owner 813-453-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1523192) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |