| NPI | 1033558614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD NIZZA President 239-246-2858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL 231023) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2013-06-18 |