| NPI | 1174762645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURICE LORENZO CEO/ President 813-926-6739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL 6180128478306) |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2009-02-06 |