| NPI | 1104559111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN ROCHE Authorized Official 813-431-6998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 104100000X Social Worker |
| 103T00000X Psychologist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208D00000X General Practice | |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-10-31 |