| NPI | 1093681215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENARA JA'NAY BLOCKER Nurse Practitioner 863-241-6642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-10-14 |
| Last Update Date | 2025-10-14 |