| NPI | 1811216286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAUTHAM SAMPATH Administrator 813-907-0233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2010-05-25 |