NPI | 1174094361 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY BRAZZLE Provider Relations Manager 954-918-7303 |
Organization Subpart ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
Enumeration Date | 2018-12-16 |
Last Update Date | 2021-07-27 |