Graduated: 1998
Also: SPORTS MEDICINE
NPI: 1023011913
Practice Locations (2)
12225 28TH ST N, SUITE B
SAINT PETERSBURG, FL 337161860
7275614303
OHI WEST MEDICAL GROUP LLC
601 7TH ST S
ST PETERSBURG, FL 337014708
7278936234
Source: CMS National Downloadable File, September 2026.