| NPI | 1821707407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA BENGSTON Manager 727-214-4622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine |
| 213E00000X Podiatrist | |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2023-12-12 |