| NPI | 1750535811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DAVID TALAKKOTTUR Owner 813-874-1852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME100711) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2012-01-09 |