| NPI | 1801638556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ORDEMAN Founder 813-810-7625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 207Q00000X Family Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-06-12 |