| 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 |