| NPI | 1235427774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STUART B KROST Owner 561-290-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0061951) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9103862) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9103888) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-11-17 |