NPI | 1912143603 |
---|---|
Entity Type | Organization |
Authorized Contact | NAVIN REDDY Medical Director 727-230-6698 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL R300620764440) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL R300620764440) |
Enumeration Date | 2008-12-30 |
Last Update Date | 2008-12-30 |