| NPI | 1265659387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAN DIAZ Credentialing COO Rdinator 813-560-8157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 2251H1200X Physical Therapist Hand |
| 225X00000X Occupational Therapist | |
| 225XH1200X Occupational Therapist Hand | |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-01-25 |