| NPI | 1730539941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOMON JOHN THEKKETHOTTIYIL Manager 727-424-8423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW10806) |
| Enumeration Date | 2016-06-18 |
| Last Update Date | 2016-06-18 |