| NPI | 1538515002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL FOSTER Owner/ Lmt 727-400-2052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL MA58664) |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-05-13 |