| NPI | 1194507921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRIA M FAIN Mngr 813-743-4383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2023-12-13 |