| NPI | 1144649492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY D QUEEN Manager 561-314-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2019-01-23 |