| NPI | 1467031195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI MAZZUCO Billing Coordinator 352-683-6831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2021-04-08 |