| NPI | 1093224032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH N GRIMAUDO Dentist 813-504-3625 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL DN12435) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL DN12435) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2025-06-13 |