| NPI | 1396037297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC M SCHABERT Owner 352-514-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL OS9641) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2011-05-10 |