| NPI | 1790931871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY CARVAJAL-PANTALEON Owner 904-461-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1313412) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2011-09-16 |