| NPI | 1043602741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JASON MULLANEY President 954-870-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL OT10332) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL OT10332) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-03-04 |