| NPI | 1902167182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI LYNN ROSSLER President 407-365-2607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL mh3167) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2012-06-04 |