| NPI | 1679736581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES D HANSON President 305-754-8613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL ME0009202) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-07-10 |