| NPI | 1689091050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE ELAINE MERDICH President 813-215-7024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL 3257532) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-03-24 |