| Organization Name: | WEST FLORIDA MEDICAL ASSOCIATES, PA |
| NPI Number: | 1144355587 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES S LI (PHYSICIAN) |
| Mailing Address: | 7647 W Gulf To Lake Hwy Crystal River |
| State: | FL US |
| Postal Code: | 344297962 |
| Phone Number: | 3527951718 |
| Fax Number: | 3527957898 |
| NPI Enumeration Date: | 02/23/2007 |
| NPI Last Update Date: | 06/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | ME0029731 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |