| NPI | 1437341070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J PENNELL Owner 954-993-7502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL AP215) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: FL MA37160) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2007-08-17 |