| NPI | 1235527706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS BENJAMIN PAGAN Physician 813-933-7805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL 0044040) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |