| NPI | 1770973224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL MARIE HAYNES Doctor/Owner 727-584-8020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL os4234) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-03-25 |