| NPI | 1760037584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH D NICHOLS Manager 813-777-4663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |