| NPI | 1285679902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL R. MOTA-CASTILLO Psychiatric/Medical Director 407-330-5818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME-82747) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |