| NPI | 1982374468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KETURAH JAROMYRE CORNEILLE Owner 407-922-3570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 251E00000X Home Health | |
| 251K00000X Public Health or Welfare | |
| 261QC1500X Clinic/Center, Community Health | |
| 305S00000X Point of Service | |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2022-02-24 |