| NPI | 1477053569 |
|---|---|
| Doing Business As | DEDICATED PENNSYLVANIA MAYFAIR |
| Entity Type | Organization |
| Authorized Contact | RAYMOND JIMENEZ Director Of Client Services 786-870-4039 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-03-27 |