| NPI | 1316646912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAYAPATHY M JOLLU Owner 352-873-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-05-12 |