| NPI | 1649212226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDE THOMAS-ELLIS Physician Assistant 954-575-4940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL PA9101194) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-08-22 |