| NPI | 1881647253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA J POULIN Credentialing Specialist 727-820-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-09-05 |