| NPI | 1477134658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL JOHNSON Administrator 561-356-6313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2021-04-19 |