| NPI | 1225467244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA LIS SANZ Owner 813-971-6204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2013-11-12 |