| NPI | 1205278264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAZIM BAKSH HAMID Administrator 813-985-8373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL ACHA 10D2061636) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: FL Reg # 10-314 (DOH)) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2013-08-13 |