| NPI | 1104418169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISMARY PADRON CEO 813-382-1172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225700000X Massage Therapist | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2022-03-15 |