| NPI | 1154286367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINE JEROME Owner/Provider 954-719-8801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-12-19 |
| Last Update Date | 2025-12-19 |