| NPI | 1801831003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY WADE Practice Administrator 941-366-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: FL ME0041874) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2021-11-05 |