| NPI | 1518458942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIVEDITHA BHASKARLA Owner 786-353-2187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME128613) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-05-22 |