Medical school: UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated: 1996
Offers telehealth
NPI: 1992702799
Practice Locations (2)
INTERCOASTAL MEDICAL GROUP INC
11505 RANGELAND PKWY
BRADENTON, FL 342114041
9419076016
LEGACY HEALTHCARE SERVICES INC
7374 SAN CASA DR
ENGLEWOOD, FL 342248842
9414175064
Source: CMS National Downloadable File, September 2026.