| NPI | 1730363896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEVAR J TOMAR Office Manager 407-682-7272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL flme44936) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2009-04-13 |