| NPI | 1073873600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARATH DIAZ Owner 407-737-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME67252) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT5845) |
| 225200000X Physical Therapy Assistant (Licence: FL PTA19539) | |
| 225700000X Massage Therapist (Licence: FL MA 64812) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-06-14 |