| NPI | 1336684034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY KENNAMER-LINN Owner 407-622-9603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL MH13013) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2017-01-04 |