| NPI | 1184309692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA TUCKER VICKERY Manager 561-212-2428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2023-06-22 |