| NPI | 1013197201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN ROMEO Owner 321-676-2012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME92448) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME92448) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-06 |