| NPI | 1184000945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE CASTELLANOS Office Manager 772-260-3082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME17655) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |