| NPI | 1780062919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAVYS HUICE Owner 813-605-4725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL HCC 10337) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2020-10-27 |