| NPI | 1508969536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSSANA MARIA DICARLO Administrator 954-456-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS5537) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH7202) |
| 208VP0000X (Licence: FL OS5537) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2025-09-11 |