| NPI | 1184862039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC THOMPSON Owner 561-964-8557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME71736) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 0063531) |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |