NPI | 1114103058 |
---|---|
Entity Type | Organization |
Authorized Contact | MELISSA ANN DEAN Owner/Physician 772-584-1212 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME98123) |
Enumeration Date | 2008-01-10 |
Last Update Date | 2012-11-14 |