| NPI | 1205836632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD EDWARD JOHNSON Owner 305-249-9925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME 11465) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2020-08-22 |