| NPI | 1194101618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLLIE ROYSTER Manager 954-530-9280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: FL os1505) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL os1505) |
| 208D00000X General Practice (Licence: FL ME79405) | |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2017-02-27 |