| NPI | 1942077383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN JONES Registered Agent 813-575-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2024-01-05 |