| NPI | 1578999652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN A QUESADA-FOX President 727-347-6450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 14650) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |