| NPI | 1811023906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA S. MAYO Director Of Operations 813-676-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 87506) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2016-01-05 |