| NPI | 1558319756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY WOLAN Controller 561-209-6108 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2019-02-21 |