| NPI | 1164100400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE D LAKES Senior Paralegal 954-446-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2025-07-14 |