Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1977
NPI: 1013026954
Practice Locations (2)
1525 KILLEARN CTR BLVD
TALLAHASSEE, FL 323093434
8508936706
LEGACY HEALTHCARE SERVICES INC
5103 COLD HARBOR DR
TALLAHASSEE, FL 323124148
8502702159
Source: CMS National Downloadable File, September 2026.