| NPI | 1821287160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK EDWARD RUIZ Owner 904-777-1979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1735590000) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2009-01-07 |