| NPI | 1861624983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES L CLAY Owner 813-884-8703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL OS7192) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-28 |