| NPI | 1639455397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANCILENE COLAS Manager 954-588-1146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2899962) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |