NPI | 1285361139 |
---|---|
Entity Type | Organization |
Authorized Contact | SHERRY HOBACK CEO 813-866-0930 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 208D00000X General Practice |
Enumeration Date | 2022-08-02 |
Last Update Date | 2024-07-30 |