| NPI | 1093812281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMAR P ROBINSON Provider Relations 813-386-4170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-07-21 |