| NPI | 1912593203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHADRICK KRALIK President/Owner 941-315-9155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2023-06-13 |