| 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 |