| NPI | 1619229226 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | REGINA F COOPER Owner 954-661-7227  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 57999)  | 
| Enumeration Date | 2012-10-05 | 
| Last Update Date | 2025-10-18 |