| NPI | 1043589625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA A WILHELM President 561-396-0563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL MA21197) |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2011-12-27 |