| NPI | 1205314804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACILIA PEREZ FERNANDEZ Owner 813-454-2252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2020-01-28 |