| NPI | 1861425423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN ALRIC PENN Owner/General Manager 786-269-9760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 210603220085) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1313226) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2007-07-25 |