| NPI | 1144602681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JOHN CARBON Manager 786-487-4535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208D00000X General Practice | |
| Enumeration Date | 2015-06-21 |
| Last Update Date | 2015-11-20 |