| NPI | 1922785419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATESWARLU MUVVA Owner 813-922-1525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2024-05-06 |