| NPI | 1992291363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELENA GORDON Office Manager 813-782-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME95221) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |