| NPI | 1881025005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGE COFFEY Owner 727-845-0609 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL AL8589) |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2013-12-13 |