| NPI | 1679140875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY HOBACK CEO 813-866-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2021-06-07 |