| NPI | 1396401048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANNY E PAULEY COO 786-924-1311 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2021-11-16 |