| NPI | 1578721684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN EUGENE GLOVER Owner/Operator 727-564-1768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251C00000X (Licence: FL 693546096) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2008-05-26 |