| NPI | 1487912341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY MARIE WATSON-DOSTER Sole Mbr 954-483-5938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL CH 10528) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2013-05-06 |