| NPI | 1508171463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN TOSOLINI Provider Relations Manager 407-375-2565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251S00000X (Licence: FL 100005094) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2021-08-02 |