NPI | 1700366010 |
---|---|
Entity Type | Organization |
Authorized Contact | MARIE BRISTER Owner/President 813-229-1924 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME118349) |
Enumeration Date | 2018-08-16 |
Last Update Date | 2018-08-16 |