| NPI | 1689979874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSY LAGOMARSINO Insurance / Billing Supervisor 407-977-7943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: FL ME75680) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-25 |