| NPI | 1962955468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER Q BOWLIN Owner, Authorized Official 813-933-6228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |