| NPI | 1134837057 |
|---|---|
| Other Name | ROOTED VIGOR, LLC |
| Entity Type | Organization |
| Authorized Contact | MARY IYESHIA GAMBLE Founder/CEO 813-397-8824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2022-11-09 |