| NPI | 1184051708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN VAES Owner 813-205-4550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL hcc9537) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2016-02-01 |