| NPI | 1134283138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE S DINOCOLA Practice Administrator 772-466-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME68275) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS6690) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2009-03-17 |