| NPI | 1083865869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIO PEREZ-VELASCO President 813-964-0595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME81174) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2024-04-23 |