| NPI | 1740064724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY C MCINTYRE Manager 813-683-2277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2023-10-06 |