| NPI | 1184089641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY R RIVERA President And CEO 813-957-0118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9177520) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2015-12-28 |