NPI | 1366992844 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY GRANT MANSELL President 561-529-2625 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL OS9748) |
Enumeration Date | 2016-10-10 |
Last Update Date | 2016-10-10 |