| NPI | 1619352283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE DOUTHAT Cdo 954-271-0485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Additional Taxonomies | 174400000X Specialist |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PMC20) | |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2016-04-07 |