| NPI | 1831508506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE JEAN LEONHARDT Owner 727-826-0838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL OS6672) |
| Additional Taxonomies | 261QE0002X Clinic/Center, Emergency Care (Licence: FL OS6672) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2017-01-26 |