| NPI | 1851622674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY S RODRIGUEZ Owner 813-443-5079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL HCC7838) |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2010-01-18 |