| NPI | 1558003202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMONE M CLEMENT-JOSEPH Manager 813-401-5958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |