| NPI | 1376904102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA L ANGEL President 954-752-9065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL DN17577) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |