| NPI | 1437383171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL MATTHEW DESANTIS, Employer 727-869-7497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME53627) |
| Enumeration Date | 2009-05-10 |
| Last Update Date | 2009-05-10 |