| NPI | 1720821135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORISMELCY DE LOS REYES PUPO Manager Member 813-445-0597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-11-01 |