| NPI | 1255476230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA BLY President 727-934-7602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL ch5006) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL CH 5006) |
| 261QR0400X Clinic/Center, Rehabilitation (Licence: FL CH 5006) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2021-09-27 |