NPI | 1215755277 |
---|---|
Entity Type | Organization |
Authorized Contact | RAFAEL MATOS Owner 813-473-8373 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208D00000X General Practice |
261QP2300X Clinic/Center, Primary Care | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2024-09-30 |
Last Update Date | 2025-04-16 |