| NPI | 1265734156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDSON RANDALL Sole Proprietor 813-244-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: FL MA44083) |
| Enumeration Date | 2010-11-26 |
| Last Update Date | 2010-11-26 |