| NPI | 1861792889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MCDONALD Billing Rep 813-651-3547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME0062100) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |