| NPI | 1952743676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BARILE Physician 239-489-2290 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME75050) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |