| NPI | 1306305891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SHADE Executive Director 727-389-3056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-03-14 |