| NPI | 1225156342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOPE LAYNE JONES Division Director 863-534-5548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL 088150300) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-11-07 |