| NPI | 1730757303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARRYD DOUGLAS LUNGER Owner/Operater 727-334-1546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2021-10-26 |