| NPI | 1871633040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE S WHIDDEN Office Manager 941-423-5053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 0066832) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS7878) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-02-10 |