| NPI | 1386818169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES D GALLAGHER Owner/President 727-786-8678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ME80813) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |