| NPI | 1497553077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY HEALD CEO 813-505-6921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083S0010X Preventive Medicine, Sports Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2025-03-07 |
| Last Update Date | 2025-03-07 |