| NPI | 1487052148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE LEE BROCK President 727-612-8031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN 5212877) |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2014-12-12 |