| NPI | 1508218496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D. BORNSTEIN Doctor 407-310-8093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL PO-1420) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |