| NPI | 1548607716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M WATROBSKY Senior Vice President 813-207-0727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |