| 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 |