| NPI | 1649862970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIKA L STEWART Director Of Clinical Services 813-519-5180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-02-08 |