| NPI | 1750587028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK T HENNESSEY Physician 407-903-0634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME63921) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: FL ME63921) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME63921) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME63921) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME63921) | |
| 208D00000X General Practice (Licence: FL ME63921) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2013-04-24 |