| NPI | 1538679576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS RICHARD OBRIEN Lpn 352-376-1611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL pn5148178) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |