| NPI | 1174058002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LYNN WALTERS Manager 813-969-4785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2017-04-28 |