| NPI | 1912768581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATA BIREDDY Owner 813-465-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |