| NPI | 1346443512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDALMIS MONTANO Clinical Director 813-884-5390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL MM19484) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-22 |