| NPI | 1750798047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE KENNETH FERGUSON President 727-842-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |