| NPI | 1851039762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK FORD Owner 813-807-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 170300000X Genetic Counselor, MS |
| 208D00000X General Practice | |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2023-05-30 |