| NPI | 1124188685 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ROCHELLE ANN ROMINES Office Manager 941-748-3065  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME41570)  | 
| Enumeration Date | 2006-12-12 | 
| Last Update Date | 2010-04-28 |