| NPI | 1386411791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS DAVID MARINO CEO 561-291-6833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2023-12-06 |