| NPI | 1497915524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY WOROBEY Billing Manager 772-403-5860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0050565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME98874) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2008-06-12 |