| NPI | 1821055690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE I DELATORRE CEO 813-780-8440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2023-03-08 |