| NPI | 1144098906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE CARLISLE Chief Operating Officer 305-299-5881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2023-12-12 |
| Last Update Date | 2023-12-12 |