| NPI | 1104056209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY HOBACK President/CEO 813-866-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 208D00000X General Practice |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2024-12-02 |