NPI | 1013902956 |
---|---|
Entity Type | Organization |
Authorized Contact | CLARA ALLYSON REYNOLDS President And CEO 813-964-1964 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: 85-8012527472C9) |
Additional Taxonomies | 261Q00000X Clinic/Center (Licence: FL 85-8012527472C-9) |
261Q00000X Clinic/Center (Licence: 85-8012527472C-9) | |
251S00000X | |
Enumeration Date | 2005-09-16 |
Last Update Date | 2017-03-30 |