| NPI | 1811120645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HOLSTEN Credentialing 727-844-5404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0044838) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2013-09-09 |