| NPI | 1831580612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JENNINGS WALLACE CEO/Medical Director 727-826-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME42522) |
| Enumeration Date | 2015-02-14 |
| Last Update Date | 2023-12-28 |