| NPI | 1194296418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA EMILY HARRISON President 954-600-6695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2018-12-14 |
| Last Update Date | 2019-06-27 |