| NPI | 1760147532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET JONIN Administrative Specialist 727-200-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2022-04-01 |