| NPI | 1194850107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM JAMES HENNE Doctor 352-242-2502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 4690780001) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2018-06-19 |