| NPI | 1326587734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASETTI HIDALGO Manager 954-740-4406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME11534) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9469600) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2025-04-17 |