| NPI | 1851080972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSELL LLORENTE Director Of Credentialing 239-208-6648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2023-05-04 |