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 |