| NPI | 1922441054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANNE MARIA RIDLEY-PAYNE Owner 813-972-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME82833) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2016-03-06 |