| NPI | 1194966275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINICK JEROME BURO Owner/Doctor 772-770-6184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL OS7615) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |