| NPI | 1619662624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA BARBER Billing & Credentialing Manager 813-734-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2023-06-28 |