| NPI | 1912646605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA OTERO Credentialing Specialist 727-683-0428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-02 |