| NPI | 1568835080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMIA GOFF Doctor 321-914-3972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL DN17172) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2015-11-05 |