| NPI | 1316237894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUTEH EGUE Owner 813-374-0104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL HCC8578) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2011-04-18 |