| NPI | 1902084940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES L. DENNIS Executive Director 321-527-2064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 261QD0000X Clinic/Center, Dental (Licence: FL 7292) | |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2011-09-21 |