| NPI | 1396168910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN MAHANY Insurance, Billing COO Rdinator 813-689-0331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: FL ME0040574) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-02-03 |