| NPI | 1730763806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAIMARYS VELAZQUEZ PEREZ CFO/Adm 813-906-2080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2024-06-06 |