Graduated: 1998
NPI: 1720207285
Practice Locations (2)
LEGACY HEALTHCARE SERVICES INC
17470 BROOKSIDE TRACE CT
TAMPA, FL 336476201
8134435042
OHI WEST MEDICAL GROUP II LLC
38135 MARKET SQUARE DR, SUITE 102
ZEPHYRHILLS, FL 335427505
8137828829
Source: CMS National Downloadable File, September 2026.