| NPI | 1093168940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA I RIOS MORALES Physical Therapist Assistant 407-968-3442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL PTA25800) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-07-15 |