| NPI | 1851621932 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | GREGORY S RODRIGUEZ Owner 813-749-7582  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL HCC7920)  | 
| Enumeration Date | 2010-01-12 | 
| Last Update Date | 2010-01-12 |