| NPI | 1821722836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARON G. DIECIDUE Chief Executive Officer 813-925-1903 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-07-21 |