| NPI | 1881754224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYAN JENELLE HARVEY-DENT Owner 813-684-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL OS8642) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL OS8642) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2019-11-05 |