| NPI | 1184931339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DERRICK CHIN-LENN President 954-322-7166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME89650) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2022-08-25 |