| NPI | 1104069418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME ISRAEL Owner 813-374-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL HCC7336) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2009-04-16 |