| NPI | 1285278135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEY WYNN Manager 954-375-1276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2022-09-20 |