| NPI | 1053615658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY ELIZABETH ELLIS Physician 954-258-0716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA 20A11353) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2010-12-22 |