| NPI | 1639672298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SORAYA JIMENEZ Billing Manager 863-385-2606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME111126) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2020-10-29 |