Graduated: 2023
NPI: 1801655071
Practice Locations (2)
OHI WEST MEDICAL GROUP LLC
603 7TH ST S
ST PETERSBURG, FL 337014719
OHI WEST MEDICAL GROUP LLC
701 6TH ST S
ST PETERSBURG, FL 337014814
7278231234
Source: CMS National Downloadable File, September 2026.