| NPI | 1841644358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY DAVID MCCONNELL President 813-404-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: FL ME83356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME83356) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: FL ME83356) | |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2021-11-19 |