NPI | 1457893869 |
---|---|
Entity Type | Organization |
Authorized Contact | CAROLINE BLANKE Owner 561-601-0999 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL AP3774) |
Enumeration Date | 2016-11-16 |
Last Update Date | 2017-03-01 |