| NPI | 1003143215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOSEPH KASS Owner 772-781-4454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL 50754) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2009-11-09 |