| NPI | 1639342645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUGHN C BENNETT Owner/Physician 305-926-5844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS5245) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |