| NPI | 1649432378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY QUAN Owner 561-748-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL CH7216) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2009-01-12 |