| NPI | 1902810963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CARL LUPO Owner/Clinic Director 813-978-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2010-08-16 |