| NPI | 1508197617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBA LILIANA GARCIA Office Manager 407-480-2786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ME95168) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-01-29 |