| NPI | 1386688257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDI LAROCHE Mso Credentialing COO Rdinator 321-449-4168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS7144) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-08-28 |