| NPI | 1568212744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE REYNOLDS Manager 954-795-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-03-22 |
| Last Update Date | 2024-05-08 |