| NPI | 1023385440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY CARPENTER Insurance Manager 561-620-7441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX H7715) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME0031479) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2012-04-17 |