| NPI | 1063680114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN FERMIN Md/ Owner 772-589-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: FL ME 94980) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |