| NPI | 1710382445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI MYRICK Administrator/Owner 941-704-6942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL 233174) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |