| NPI | 1982990545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMISELA CORDERO Manager 813-249-7374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: FL HCC8923) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2021-02-08 |