| NPI | 1871891648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEGO ESTIGARRIBIA Medical Biller 941-753-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ME39298) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2011-03-03 |