NPI | 1992188015 |
---|---|
Entity Type | Organization |
Authorized Contact | GRACE LEVY-CLARKE Director 727-317-5830 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME99689) |
Enumeration Date | 2015-07-07 |
Last Update Date | 2020-06-12 |