| NPI | 1285990762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLINE ROBERTS JACKSON Administrator 954-821-7511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL AL10291) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |