| NPI | 1619790334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JITHU A ABRAHAM Owner 813-280-4838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-11-01 |
| Last Update Date | 2024-11-13 |