| NPI | 1134645435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PERRY Medical Director 813-289-9613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-07-21 |