| NPI | 1770961831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID FRANK Mgr 813-606-4002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: FL ME41659) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME41659) |
| 207R00000X Internal Medicine (Licence: FL ME41659) | |
| Enumeration Date | 2015-05-09 |
| Last Update Date | 2015-05-09 |