| NPI | 1700234358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA SHALLONIS Billing Manager 352-399-5085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: NY 239768) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |