| NPI | 1386060580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEREIDA PADILLA Pharmacist In Charge 407-513-8626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-03-12 |