| NPI | 1538338991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE DEANE CARR Md/Owner 863-382-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL ME40000) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME40000) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2015-05-07 |