| NPI | 1710570734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAIN SANTOS PEREZ Owner 813-269-2920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2024-06-19 |