| NPI | 1295282978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA JEAN PIERRE CEO 863-212-4777 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL 20866) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2016-09-09 |