| NPI | 1356940431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATINA P DAVIS-KENNEDY Owner 954-231-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2023-08-23 |