NPI | 1811975535 |
---|---|
Entity Type | Organization |
Authorized Contact | ELODIE DORSO President CEO 727-821-8100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
207V00000X Obstetrics & Gynecology | |
208000000X Pediatrics | |
Enumeration Date | 2006-01-03 |
Last Update Date | 2019-12-11 |