| NPI | 1245407394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN O. LOLI Director Of Operations 305-754-8967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2010-09-09 |