| NPI | 1053362665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA BURKE Credentialing Manger 954-563-4472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 74548) |
| 207R00000X Internal Medicine (Licence: FL ME 81676) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-09-13 |