| NPI | 1811152366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAFIYA A GORDON President 727-320-7879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9176677) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-30 |