| NPI | 1447923099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE LYNNE BRUNET Owner 813-254-3707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083S0010X Preventive Medicine, Sports Medicine |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 261Q00000X | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2021-07-29 |