| NPI | 1659067460 |
|---|---|
| Other Name | FLLAKE |
| Entity Type | Organization |
| Authorized Contact | LORA MORSE VP Professional Fee Services 321-434-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-04-18 |