| NPI | 1457671554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN PADGETT Owner 813-888-7710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: FL PMC1620) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2016-03-11 |