| NPI | 1124751003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISHA SILVA Director Of Credentialing 561-432-5849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2023-03-01 |