| NPI | 1912129214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX HALL Administrator 772-287-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 666) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |