| NPI | 1134669823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYRA Z RAVELO President 904-763-8467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |