| NPI | 1609995489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE LUCAS Billing COO Rdinator 813-653-2775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0043683) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |