NPI | 1265581383 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBORAH E INGRAM Physician/Owner 954-321-1591 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME79116) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2022-06-16 |