| NPI | 1063653079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYUBOV PAK President 954-454-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: FL OS 8239) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2009-03-20 |