| NPI | 1073883971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIJAY J MORADIA Managing Member 386-756-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME 62606) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2012-01-09 |