| NPI | 1598118606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YURIY CHULSKIY Senior Associate Athletic Trainer 813-974-6794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL AL2936) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |