| NPI | 1144491648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUDER A. COUTINHO Director Of Business 850-232-8582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL CBC1254272) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2008-03-12 |