| NPI | 1013006899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L ROACH Administrator 954-467-4811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: FL PH13091) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |