| NPI | 1831440155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA MORAME CEO 863-269-9753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL 6906270) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-09-26 |