NPI | 1083346092 |
---|---|
Entity Type | Organization |
Authorized Contact | NICOLE M CAMACHO CRUZ CEO 321-314-3620 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 207Q00000X Family Medicine |
251B00000X Case Management | |
251S00000X | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2022-06-28 |
Last Update Date | 2023-09-20 |