| NPI | 1336165349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANISLAV PORTNOV Office Director 954-486-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 91789) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-10-26 |