| NPI | 1164585774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAN DIAZ Cc 813-560-8157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 225XH1200X Occupational Therapist Hand | |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2022-11-30 |