| NPI | 1205275401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASVENDAR SINGH NANDRA CEO 407-921-2074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL ME85696) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2013-06-20 |