| NPI | 1053158352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA LARSON HUSSAIN Administrator 813-388-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-15 |