| NPI | 1699367417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAFAA GANDARILLAS Owner 727-744-7189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2022-12-29 |