| NPI | 1184074379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN FRANCIS LICA Managing Member 954-854-6756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL 78028) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2016-06-17 |