NPI | 1356679989 |
---|---|
Entity Type | Organization |
Authorized Contact | IVORY J CHRISTEN Vice President 954-894-0522 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ME0049240) |
Additional Taxonomies | 208D00000X General Practice (Licence: FL ARNP1714142) |
208D00000X General Practice (Licence: FL OS0001922) | |
208D00000X General Practice (Licence: FL OS0007497) | |
Enumeration Date | 2009-11-19 |
Last Update Date | 2009-11-19 |