| NPI | 1124201991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTINE BOLLO Physician 954-389-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL PO02570) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2007-12-19 |