| NPI | 1487794681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R HAYES CEO 772-216-1871 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME46941) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2008-01-07 |