| NPI | 1659386043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAB J. HALBERG Owner/President 239-481-3404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PED 97) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-04-20 |