| NPI | 1134312770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA A ELIZEE Office Administrator 305-754-8966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL HCC6998) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |