| NPI | 1770413445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOAN LAM Owner 813-212-6517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| Enumeration Date | 2026-05-22 |
| Last Update Date | 2026-06-23 |