| NPI | 1396590659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ANDREA VON DER HEYDE Manager 786-291-2508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-04-20 |
| Last Update Date | 2024-08-05 |