| NPI | 1851746937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINE JACQUES President 813-764-1732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 10d2115859) |
| Additional Taxonomies | 251B00000X Case Management |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-08-04 |