| NPI | 1376603480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA T. BRADLEY Clinical Manager 954-480-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC4139) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-08-28 |