| NPI | 1194256388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE A. FORSTER Owner 813-782-9564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ch0003767) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |