| NPI | 1992851620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK EDWARD SCHIAVONE Sole Proprietor 904-354-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME41919) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2012-03-20 |