| NPI | 1881216224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNE EVELYN DIPASQUA Credentialing Specialist 941-757-4810 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |