| NPI | 1750518742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE MONTOYA Owner 813-935-5709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL mm23091) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |