| NPI | 1407666134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS GONZALEZ-ROMAN Owner 813-502-9354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-01-23 |