| NPI | 1245428440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAYSI SALINAS Director Of Operations/Owner 813-205-4469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2007-12-17 |