| NPI | 1922274398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDI LAROCHE Mso Credentialing COO Rdinator 321-449-4168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME49690) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2009-04-07 |