| NPI | 1487860136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA WELLISCH Vice President 305-242-0883 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: 9611161) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2008-07-16 |