| NPI | 1568576908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN SHAUN VINIK President 561-391-1085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2023-05-19 |