Medical school: UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Graduated: 1978
NPI: 1700074432
Practice Locations (2)
LEGACY HEALTHCARE SERVICES INC
17470 BROOKSIDE TRACE CT
TAMPA, FL 336476201
8134435042
3500 E FLETCHER AVE, SUITE 301
TAMPA, FL 336134797
8139712351
Source: CMS National Downloadable File, September 2026.