| NPI | 1326393851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIS M ALFONSO Physician 321-289-9287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME 100641) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2013-02-02 |