| NPI | 1891150488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA WANDA GLUSZAK Practice Manager 813-699-4020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME104526) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME104526) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2019-03-25 |