| 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 |