| NPI | 1376682559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDI LAROCHE Mso Credentialing COO Rdinator 321-449-4168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2010-04-28 |