| NPI | 1023729084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRMARIE DIAZ FERNANDEZ Medical Director 352-308-1485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-12 |