| NPI | 1609297928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BRUNTON Owner 727-580-9131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL 2776972) |
| Enumeration Date | 2014-01-05 |
| Last Update Date | 2014-01-05 |