| NPI | 1104291517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRODES H HARTLEY Credentialing Specialist 305-253-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |