| NPI | 1831474303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN B DECOSMO President 727-498-6488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL OS5534) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2015-04-12 |