| NPI | 1932339926 |
|---|---|
| Doing Business As | PRIMECARE MEDICAL OF LAND O LAKES |
| Entity Type | Organization |
| Authorized Contact | MARTIN REVELLO President 813-932-0996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME80045) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2010-05-03 |