| NPI | 1134992688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SHOOK President 813-325-7479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2024-07-24 |