| NPI | 1396972006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XINMIN TANG Director 813-792-4804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: ME 96528) |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2023-04-25 |