NPI | 1538355508 |
---|---|
Entity Type | Organization |
Authorized Contact | STUART B KROST Owner 561-296-2220 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL 661951) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9103862) |
363AM0700X Physician Assistant, Medical (Licence: FL PA9103888) | |
Enumeration Date | 2007-09-24 |
Last Update Date | 2011-12-02 |