| NPI | 1902473101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY HOBACK CEO 813-866-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2021-06-07 |