| NPI | 1144770686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH IRIS HERNANDEZ CEO 772-828-6992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: FL ME83014) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |