| NPI | 1083297360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA DIANE CONSTANT Manager 954-816-2848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |