| NPI | 1326235672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN COLON Owner 727-834-8833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: FL ME56685) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME966525) |
| 363L00000X Nurse Practitioner (Licence: FL ARNP1363142) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2008-02-15 |