| NPI | 1275943177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIS GOMEZ Presidant 813-605-0781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL MM35115) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL MM 32182) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2022-07-21 |