| NPI | 1023195658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIO AQUILES GRISALES Owner Provider 813-908-7868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME79046) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-02-11 |