| NPI | 1548470040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA CHACON Owner 813-514-6623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL HCC 7340) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |