Graduated: 2022
NPI: 1720793664
Practice Locations (2)
FLORIDA DEPARTMENT OF HEALTH
7551 FOREST OAKS BLVD
SPRING HILL, FL 346062437
3525406800
FLORIDA DEPARTMENT OF HEALTH
1105 E KENNEDY BLVD, HILLSBOROUGH COUNTY HEALTH DEP.
TAMPA, FL 336023511
81330780156401
Source: CMS National Downloadable File, September 2026.