| NPI | 1215536552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIUBIS MIRANDA Owner 813-527-4197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |