Graduated: 2006
NPI: 1619007002
Practice Locations (2)
LEGACY HEALTHCARE SERVICES INC
17470 BROOKSIDE TRACE CT
TAMPA, FL 336476201
8134435042
MOBILE PHYSICIANS TEAM, LLC
1225 HAVENDALE BLVD NW
WINTER HAVEN, FL 338811349
8632986717
Source: CMS National Downloadable File, September 2026.