| NPI | 1679993810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY ANN VASILE Owner 941-225-4327 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2017-01-17 |