| NPI | 1609120534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATA JAYA PRATAP BIREDDY Owner/Administrator 813-465-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2024-01-19 |