| NPI | 1063687507 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JOHN MICHAEL FORREST Physician 954-583-6311  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0062996)  | 
| Enumeration Date | 2008-04-25 | 
| Last Update Date | 2008-04-25 |