| NPI | 1386746774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD CHANNING BASS President 954-873-8545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME14256) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2011-05-25 |