| NPI | 1508199175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LOPEZ Manager 813-735-3595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: FL MA53981) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2022-07-21 |