| NPI | 1114880994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMANN A LANGE CEO 786-564-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2025-12-08 |