| NPI | 1366615254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M EDGERTON President 786-390-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS 8636) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2008-04-11 |