| 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 |