| NPI | 1306568803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY BURTON President And Sole Shareholder 813-990-7604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2025-10-24 |