| NPI | 1194393413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN ALLEN FOURMAN Administrator 727-541-4239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |