NPI | 1780083501 |
---|---|
Entity Type | Organization |
Authorized Contact | JUAN FRANCISCO PRADO Owner 813-968-1373 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL DN20896) |
Enumeration Date | 2014-08-18 |
Last Update Date | 2014-08-18 |