| NPI | 1356741037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS MERCED Medical Director 813-932-1410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL ME55872) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2014-08-29 |