| NPI | 1497109383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GONZALO MOSQUERA Director/President 813-380-1761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL me0071342) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |