Medical school: UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Graduated: 1979
NPI: 1992724736
Practice Locations (2)
OHI WEST MEDICAL GROUP II LLC
14014 N 46TH ST, SUITE C
TAMPA, FL 336134238
8132842229
LEGACY HEALTHCARE SERVICES INC
17470 BROOKSIDE TRACE CT
TAMPA, FL 336476201
8134435042
Source: CMS National Downloadable File, September 2026.