| NPI | 1033806302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YESENIA GONZALEZ-VALDEZ Owner 813-300-0012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |