| NPI | 1134218357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMESHWAR N MATHUR Director 321-631-6402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0044769) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME0046184) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |