| NPI | 1578924353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN SIMEON PENA Self 813-879-3530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP 9288272) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-05-11 |