| NPI | 1386895472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUSDANIA AMARO Office Manager 813-935-1944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2012-09-17 |