| NPI | 1619485190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIAANN LEE HAYES-HURST President, Owner 772-521-3638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL AP3906) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |