| NPI | 1851520795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERI ANN HERRO President 813-741-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL CH9651) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2009-07-14 |