| NPI | 1215462601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJESH GUTTA Manager 321-223-1707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME82777) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |