| NPI | 1134952757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRECIA SOFIA IBARRA Owner 813-850-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |