| NPI | 1447684170 |
|---|---|
| Other Name | SAME |
| Entity Type | Organization |
| Authorized Contact | ROBERT J BUCK Medical Director 321-217-7950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL PA-9100248) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |