| NPI | 1952801581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSMIN RIVERO IZQUIERDO Administrator 813-542-4228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC11203) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-02-20 |