| NPI | 1881053684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE CONSUEGRA President 813-454-2715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL HCC10578) |
| Additional Taxonomies | 111N00000X Chiropractor |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2020-09-21 |