| NPI | 1104022169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA CHARLES Nurse Practitioner 954-990-0461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1956772) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2015-03-30 |