| NPI | 1821023144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS B ANDERSON Owner 727-859-4362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0072524) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |