| NPI | 1952923864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN K DE LEON Member Manager 561-215-5067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-05-13 |