NPI | 1710550553 |
---|---|
Other Name | COUNTRYSIDE III |
Entity Type | Organization |
Authorized Contact | LYNDA GORKEN VP, PFS 727-281-9202 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
Enumeration Date | 2021-07-20 |
Last Update Date | 2021-07-20 |