| NPI | 1508172206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C MARTINEZ VP Operations & Network Mngt 954-703-6065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 302F00000X Exclusive Provider Organization | |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2015-02-25 |