| NPI | 1740483833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN JIMENEZ YANDEK Director Credentialing/Billing 727-430-3291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2022-02-18 |