| NPI | 1710136064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY A WUBBENA President 813-388-6632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME43369) |
| Additional Taxonomies | 2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging (Licence: FL ME43369) |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: FL ME43369) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL ME43369) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: FL ME43369) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: FL ME43369) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9104389) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |