| NPI | 1336387489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGARDO CRUZ-MARTINEZ Registered Agent 352-748-6253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME78169) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2012-04-12 |