| NPI | 1841579778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YSMARAY DIAZ Owner 813-506-4419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL MA62393) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2022-07-21 |