| NPI | 1982089561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYAM BEHDARVANDI Provider 813-340-0901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL PY6701) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-07-24 |