NPI | 1215394846 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN MAS Owner/Therapist 407-850-2116 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL 5303) |
Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: FL 5303) |
Enumeration Date | 2016-01-27 |
Last Update Date | 2016-01-27 |