| NPI | 1679916175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL HIGGINBOTHAM Owner 813-933-1199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL HCC10697) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2014-08-02 |