| NPI | 1629304936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL M DAILY Executie Director 305-246-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: FL 261QP2300X) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2009-10-20 |