| NPI | 1548147614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THALIA RIVES Owner 813-325-0043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-10-01 |