| NPI | 1992302574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY M SEGARRA President 813-330-2737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2021-09-02 |