| NPI | 1932390697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO VALIENTE General Manager 813-968-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL 15074) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2014-08-20 |