| NPI | 1326478942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE DE LA TORRE Owner 813-309-1013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME89848) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME89848) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-12-09 |