| NPI | 1063567758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SID DUANE RUSSELL Secretary Treasurer 352-401-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL 1313210) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2008-02-04 |