| NPI | 1780906065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP MAZZUCO Owner 352-683-6831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2010-02-27 |
| Last Update Date | 2010-02-27 |