| NPI | 1629446810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS W TYSON Administrator 407-925-7237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0600X Registered Nurse, Gerontology |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2015-09-04 |