| NPI | 1154599132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN VICTORIA BROWN Office Manager 407-333-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-02-13 |