| NPI | 1639346406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN CARSON Manager 813-968-5465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL fl1402) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2013-04-02 |