| NPI | 1780066597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT OBRIEN ELLIOTT Owner 813-381-3852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT3274) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3574) |
| 225200000X Physical Therapy Assistant (Licence: FL PTA23287) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3352) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-07-21 |