| NPI | 1396638755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENET FANFAN Owner / Authorized Official 561-568-5728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-07-10 |