| NPI | 1295832343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN BRUCE HAYES Medical Doctor/Owner 321-733-2201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME69211) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-10-12 |