NPI | 1265824387 |
---|---|
Entity Type | Organization |
Authorized Contact | ISABEL PANESSO Credentialing 561-200-2566 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL LC11484) |
Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: FL LC11484) |
207Q00000X Family Medicine (Licence: FL LC11484) | |
247100000X Radiologic Technologist (Licence: FL LC11484) | |
261QI0500X Clinic/Center, Infusion Therapy (Licence: FL LC11484) | |
Enumeration Date | 2015-02-26 |
Last Update Date | 2022-07-21 |