| NPI | 1902162290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH RUNYAN Owner 727-345-3908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME62416) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |