| NPI | 1538895636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARDINE JACQUES Nurse Practitioner 305-519-7951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2024-04-16 |