| NPI | 1740931831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARTINEZ Admin 813-335-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-01-24 |