| NPI | 1598154890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERLY J VARGHESE Office Manager 386-209-5518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME67182) |
| Enumeration Date | 2015-01-10 |
| Last Update Date | 2015-01-10 |