| NPI | 1407120298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WELLS AGUIAR Managing Member 813-658-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME82789) |
| Additional Taxonomies | 261Q00000X (Licence: FL ME82789) |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2012-10-18 |