| NPI | 1790184125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL LUIS VIERA Owner 813-520-2501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL MM32075) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |