| NPI | 1306037155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN O'GORMAN Owner 954-938-4321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: FL CH8533) |
| Additional Taxonomies | 261Q00000X (Licence: FL CH 8533) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2011-12-08 |