| NPI | 1124587100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE A EVERSLEY-HALL Nurse Practitioner 954-532-3084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2021-03-22 |