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Doctors / FL
FAMILY PRACTICE
Medical school: CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2002
NPI: 1366429011
8643 MAMMUT WAY
MELBOURNE, FL 329408805
2728 CEDAR SPRINGS RD, APT 1602
DALLAS, TX 752011365
Source: CMS National Downloadable File, September 2026.