| NPI | 1386999589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS BAYOLO Propietary 813-605-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ACN247) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2015-09-15 |