| NPI | 1376981985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMAN GROCHOWSKI Administrator/Owner 772-460-8007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL 8841) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |