| NPI | 1114592029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA HERNANDEZ Manager 561-300-2410 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2022-02-23 |