| NPI | 1194240606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANDANA RAMAIAH Program Director 727-687-9102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335G00000X Medical Foods Supplier (Licence: FL L17000121902) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2022-07-21 |