| NPI | 1093720427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUL REVELLO Medical Director 813-932-0996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me35878) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |